• Coagulopathy (prothrombin time > 18 seconds).
• Thrombocytopenia (platelet count < 100,000/mcL).
• Recent intestinal tract surgery (< 1 month ago).
• Lubricant gel.
• Nasogastric (NG) tube.
• Larger diameter, polyethylene NG tube for suction and decompression.
• Smaller diameter, silicone NG tube for enteral feeding.
• Water or normal saline at room temperature.
• Drainage bag or feeding pump.
• 60-mL catheter tip syringe.
• Measure length of tube insertion by positioning
the tube from the nares or mouth to the ear, then to the umbilicus.
• There is also a standard table, which uses height of child.
• If the tube is obstructed, flush first with water; longstanding
obstruction may be removed by flushing the tube with caffeinated
• Ask the patient to cooperate by swallowing while
the tube is being inserted.
• Advance the tube to the length mark.
• To check position, aspirate tube with 50-mL syringe (Figure 25–3); gastric aspirate (pH = 1–3)
confirms positioning in stomach.
• Insert small amount of air (20–30 mL)
via NG tube while listening to epigastric area of stomach with stethoscope.
• If unsure about tube placement, verify tube position by obtaining
a chest film before starting enteral feeding or drug treatment.
• Secure tube to the face with tape.
Measuring the length of tube for insertion.
Inserting the nasogastric tube.
Checking the position of the tube.
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